On September 14, 2018, the U.S. Food and Drug Administration (FDA) approved fremanezumab-vfrm (Ajovy)for the preventive treatment of migraine in adults. The drug may be administered as either 225 mg monthly, or 675 mg quarterly, subcutaneous doses. Fremanezumab-vfrm is a humanized monoclonal antibody that binds to calcitonin gene-related peptide (CGRP), thereby blocking the binding of the ligand to its receptor. The monoclonal antibody erenumab-aooe (Aimovig), which was approved by the FDA in May 2018 for the preventive treatment of migraine in adults, targets CGRP receptor, rather than the ligand. Marketing applications for galcanezumab, another monoclonal antibody that targets CGRP, are undergoing review by FDA and the European Medicines Agency.

The Antibody Society maintains a comprehensive table of approved mAb therapeutics and those in regulatory review in the EU or US. As of September 14, a total of 9 antibody therapeutics had been granted first approvals in either the US or EU in 2018, and marketing applications for another 7 that have not yet been approved in either the EU or US are undergoing review in these regions. Please log into access the table in either PDF or Excel formats, located in the Members Only section.

On September 13, 2018, theU.S. Food and Drug Administration approved moxetumomab pasudotox-tdfk(Lumoxiti) for the treatment of adult patients with relapsed or refractory hairy cell leukemia (HCL) who have received at least two prior systemic therapies, including treatment with a purine nucleoside analog. The drug is a recombinant immunotoxin targeting CD22 composed of an IgG1 kappa variable fragment fused to a truncated form of Pseudomonas exotoxin PE38. In a pivotal, multicenter, open-label study of moxetumomab pasudotoxinvolving 80 patients (79% males; median age, 60.0 years), the durable complete response (CR) rate was 30%, CR rate was 41%, and the objective response rate (CR and partial response) was 75%. Due to the severity and rarity of the disease, the FDA granted the application Fast Track and Priority Review designations and the molecule received US Orphan Drug designation.

The Antibody Society maintains a comprehensive table of approved mAb therapeutics and those in regulatory review in the EU or US. As of Sep 13, a total of 8 antibody therapeutics had been granted first approvals in either the US or EU in 2018, and marketing applications for another 8 that have not yet been approved in either the EU or US are undergoing review in these regions. Please log into access the table in either PDF or Excel formats, located in the Members Only section.

On September 3, 2018 Sanofi announced that the European Commission granted a marketing approval for caplacizumab (Cablivi),a bivalent single-domain Nanobody targeting von Willebrand factor, as a treatment of adults experiencing an episode of acquired thrombotic thrombocytopenic purpura (aTTP). During episodes of this rare, life-threatening blood clotting disorder, microclots can form, leading to low platelet counts, ischemia and organ dysfunction in aTTP patients. Caplacizumab was granted Fast Track designation in the US and orphan drug designations in the US and EU for the treatment of aTTP. The biologics license application (BLA) for caplacizumab is undergoing a priority review at the US Food and Drug Administration (FDA). A first action by FDA is expected by February 6, 2019. Caplacizumab was developed by Ablynx, a Sanofi company.

The approval of caplacizumab in the European Union was based in part on the Phase 3 HERCULES study (NCT02553317), a placebo-controlled, randomized study to evaluate the efficacy and safety of caplacizumab in more rapidly restoring normal platelet counts as a measure of the prevention of further microvascular thrombosis. Positive results from this studywere announced in October 2017. The HERCULES study recruited 145 patients with an acute episode of aTTP who were randomized 1:1 to receive either caplacizumab or placebo in addition to standard-of-care treatment, which was daily plasma exchange (PEX) and immunosuppression. Patients were administered a single IV bolus of 10 mg caplacizumab or placebo followed by daily SC dose of 10 mg caplacizumab or placebo until 30 days after the last daily PEX. Depending on the response, the treatment could be extended for additional 7-day periods up to a maximum of 28 days. The primary endpoint (time to platelet count response) and several secondary endpoints of HERCULES study were met. In particular, there was a statistically significant reduction in time to platelet count response, with, at any given time, patients treated with caplacizumab 50% more likely to achieve platelet count response; a 74% relative reduction in the percentage of patients with aTTP-related death, a recurrence of aTTP, or at least one major thromboembolic event during the study drug treatment period; and a 67% relative reduction in the percentage of patients with aTTP recurrence during the overall study period. A 3-year Phase 3 follow-up study (NCT02878603) of patients who completed the HERCULES study is in progress.

The Antibody Society maintains a comprehensive table of approved mAb therapeutics and those in regulatory review in the EU or US. As of Sep 3, a total of 7 antibody therapeutics had been granted first approvals in either the US or EU in 2018, and marketing applications for another 9 that have not yet been approved in either the EU or US are undergoing review in these regions. Please log into access the table in either PDF or Excel formats, located in the Members Only section.

On August 23, 2018, the U.S. Food and Drug Administration (FDA) approved TAKHZYROinjection for prophylaxis to prevent attacks of hereditary angioedema (HAE) in patients 12 years of age and older. This rare, genetic, and potentially life-threatening disorder can result in recurrent attacks of severe swelling in various parts of the body, including the throat. HAE affects people with low levels of, or poorly functioning, C1 esterase inhibitor proteins, which function by inhibiting plasma kallikrein and preventing spontaneous activation of the complement system. TAKHZYRO is a human monoclonal antibody (mAb) that targets plasma kallikrein, and thereby helps prevent attacks of edema.

FDA’s approval of TAKHZYRO was based in part on data from a multicenter, randomized, double-blind, placebo-controlled, parallel-group, Phase 3 study (NCT02586805) that included 125 patients with HAE. In this study, TAKHZYRO reduced the number of monthly HAE attacks an average of 87% (n=27) or 73% (n=29) vs. placebo (n=41) when administered subcutaneously at 300 mg every two weeks or at 300 mg every four weeks, respectively (adjusted P<0.001). The FDA had previously granted TAKHZYRO Breakthrough Therapy and Orphan Drug designations. The biologics license application for the drug was granted a priority review.

The Antibody Society maintains a comprehensive table of approved mAb therapeutics and those in regulatory review in the EU or US. As of Aug 23, a total of 6 antibody therapeutics had been granted first approvals in either the US or EU in 2018, and marketing applications for another 10 that have not yet been approved in either the EU or US are undergoing review in these regions. Please log in to access the table in either PDF or Excel formats, located in the Members Onlysection.

On August 8, 2018, the U.S.Food and Drug Administration (FDA) approved Poteligeo(mogamulizumab-kpkc) for intravenous use for the treatment of adult patients with relapsed or refractory mycosis fungoides (MF) or Sézary syndrome (SS) after at least one prior systemic therapy. The diseases are subtypes of cutaneous T-cell lymphoma (CTCL), which is a rare and difficult-to-treat type of non-Hodgkin lymphoma. The FDA had previously granted mogamulizumab Breakthrough Therapy and Orphan Drug designations, and the biologics license application for mogamulizumab received a priority review.

FDA’s approval was based on an open-label, multi-center, randomized Phase 3 clinical trial (NCT01728805) of 372 patients with relapsed MF or SS who received either mogamulizumab or vorinostat. Study sites were located in the US, Europe, Japan and Australia. Median progression-free survival was 7.6 months for patients administered mogamulizumab compared to 3.1 month for patients taking vorinostat in this clinical trial.

Developed by Kyowa Kirin, mogamulizumab is a humanized glyco-engineered monoclonal antibody that binds to CC chemokine receptor type 4 on cancer cells. Mogamulizumab was produced using Kyowa Hakko Kirin’s proprietary POTELLIGENT® platform, which produces antibodies with low / no fucose content. Such antibodies have increased affinity to FcγRIIIa (CD16), and enhanced antibody-dependent cell-mediated cytotoxicity activity. Mogamulizumab’s first approval, in 2012, was granted by the Japanese Ministry of Health, Labour and Welfare for treatment of patients with relapsed or refractory CCR4-positive adult T-cell leukemia-lymphoma.

The Antibody Society maintains a comprehensive table of approved monoclonal antibody therapeutics and those in regulatory review in the EU or US. As of Aug 8, a total of 5 antibody therapeutics had been granted first approvals in either the US or EU in 2018, and marketing applications for another 11 that have not yet been approved in either the EU or US are undergoing review in these regions. Please log into access the table in either PDF or Excel formats, located in the Members Only section.